pregnancy

Effective Ways to Deal with Postpartum Depression and Anxiety

Feeling like a hot mess after having your baby?

Are you blitzed out in love but also feel like you want to crawl into a hole and disappear? Or are you awake at night worrying even though you need sleep more than anything? Are you having trouble wanting to hold your baby and then feeling guilty about it?

You’re not a bad mom. Your hormones are just scrambled.

While a few days of hormone crash or baby blues is common, anything beyond that is a sign of postpartum depression or anxiety. Having a baby should be one of the happiest times of your life, right?

Sadly, though, many of us feel unhappy after our baby is born and suffer from postpartum depression. The Centers for Disease Control (CDC) says one in eight new mothers have this condition.

In my experience, it’s more like one in three.

Motherhood turns our worlds upside down and there’s no getting around that. But postpartum depression or anxiety makes it so much harder. Keep reading to learn why you’re feeling blue and how to get back to normal as soon as possible after birth. It’s a wild ride and you deserve to feel good while you bond with your new baby and adjust to your new life.

What is Postpartum Depression?

Postpartum depression is a feeling of sadness that new mothers experience after giving birth. Symptoms of postpartum depression include:

Feeling angry
Crying more often
Postpartum mood swings
Not communicating, or withdrawing from others
Feeling numb
Worrying about harm coming to the baby
Worrying you’ll harm the baby*
Preoccupied with the sense that you’re not a good mom
Feeling like you won’t do a good enough job caring for your baby

Sound familiar? Anyone? If so, raise your hand.

* If you feel concerned you might actually harm your baby, please speak with a professional. Generally, your OBGYN office is a really supportive place to start.

Is It Postpartum Depression or Baby Blues?

Postpartum depression isn’t the same as baby blues. Postpartum depression lasts longer than two weeks and can hang around for four years or longer.

Baby blues, on the other hand, usually appear soon after delivery and last only up to ten days after birth. Baby blues are related to the exhaustion from labor and giving birth, as well as the effects of the heroic hormonal shift that occurs during this time.

Baby blues are a normal part of giving birth. They happen in up to 85% of new mothers. Symptoms of this emotional condition may include crying for no reason, irritability, restlessness, and anxiety. These symptoms last a week or two and generally resolve on their own without treatment. Postpartum depression, on the other hand, can be a lot more severe.

Postpartum depression tends to show up within the first month after delivery—usually after the first ten days. Sometimes it can start as baby blues, which turns into a second wave of postpartum depression. You might even be able to tell when baby blues turns into something more.

When You Worry Too Much About Your Baby

Postpartum anxiety is also a real thing. In this condition, new mothers obsessively worry about the health and well-being about their child. Symptoms can include:

Constant or near-constant worry
Feelings of dread and fear about things that could happen
Insomnia even when your baby is sleeping
Thoughts that won’t calm down

You can also have physical symptoms of postpartum anxiety. These include fatigue, heart palpitations, sweating, nausea, shaking, and hyperventilating.

In modern times, we have so many apps and methods to track a baby’s health and progress. Postpartum anxiety might show up as excessively tracking baby’s metrics like feedings, liquid, wet or dirty diapers, etc. If it feels like you are over-focused on this and it is not medically necessary, or if it is adding to your anxiety, consider if tracking your baby’s metrics is best for you. If you are Googling about your baby’s well-being much more than what seems appropriate, it may be a sign of postpartum anxiety.

The Heroic Hormonal Shift

Can’t relate with those magazine-ad mommies who are wearing their new baby while going for hikes in the beautiful outdoors, gorgeous hair whipping in the wind? How about those well dressed and fully makeup’d Instagram influencers?

It’s easy to compare. We’re all guilty to some extent. And while I won’t tell you to stop (easier said than done), I do want to encourage you to try and stay true to yourself and the things you love about you.

This is NOT a moment of weakness. Hormonal changes, depression, and anxiety make this so much easier said than done. It’s cloudy. It’s dark. It’s confusing. It’s a roller coaster. Remember that every single journey is different. Everybody is different and every healing journey looks different, even from someone you may know really well.

When you’re giving birth, your progesterone levels take a nosedive. At the same time, estrogen levels increase. This hormonal shift is what causes the uterine contractions that lead to delivery of the baby.

That’s a good thing. The bad news, though, is that this puts you into a near-instant state of estrogen dominance.

This is a heroic amount of hormonal shift. And it happens in just this one moment of pregnancy.

This sudden dramatic drop off of both estrogen and progesterone essentially mimics menopause.

Interestingly, these changes depend as much on the hormones of the baby, as they do on the mother’s! This is why induced deliveries** are more likely to require hormonal interventions after to restore a mother’s good mood and well-being. When a birth is induced, the hormonal cascades that promote the stages of labor aren’t encouraged in the same way.

Induced labor triggers the release of higher levels of the stress hormone cortisol in the baby. This in turn leads to a drop in progesterone, just like you would experience before your period. Only it’s much more dramatic because progesterone levels are 20 times higher in pregnant women.

Whether labor is induced or occurs naturally, the resulting hormonal changes happen relatively quickly. But it can take a long time to restore them to a more balanced state.

The postpartum period is defined as six to twelve weeks after delivery. Yet, sometimes it takes up to four years for out-of-whack hormones to rebalance themselves. This usually depends upon the stage of your reproductive cycle when you give birth. By that I mean, are you 20-years-old when delivering your baby or 45-years-old and perimenopausal?

During and after birth, new mothers also produce high levels of a hormone known as oxytocin. This is sometimes called the bonding hormone or love molecule. This is because it leads to feelings of euphoria and connection. It makes you love and want to take care of this tiny, needy little animal you have created. Oxytocin is triggered at birth, by touch, and by breastfeeding. It helps take the sting out of the other hormones dropping so severely.

**Please note: Whether you chose or needed a certain intervention in your birth plan, there is no judgement or shaming intended here. We are just talking about the evidence related to these labor and delivery events. Many women dream of the “perfect birth,” and few of us get it.

Hormonal Causes of Postpartum Depression and Anxiety

One or more of four hormones tend to be out of whack in women who are depressed or anxious after giving birth.

Thyroid Hormones

The thyroid works extra hard in pregnancy. It generally returns to pre-pregnancy levels within six weeks after you’ve given birth. But if it’s not working properly this can create depression, anxiety, or fatigue. In this case, a women can have an overactive thyroid (hyperthyroid) or a sluggish thyroid (hypothyroid).

New mothers could also develop thyroid autoimmunity (Hashimoto’s or Graves’ disease). Or they can have a flare-up of a pre-existing thyroid autoimmune condition.

Women who have higher levels of antibodies known as thyroid peroxidase antibodies (TPO), which indicate Hashimoto’s disease, have higher risk for postpartum depression. The same is true for women with lower levels of the thyroid hormone known as free T4.

Cortisol

This is the stress response hormone. Your body produces it according to a circadian rhythm every day. During regular daily life, cortisol is high in the morning and lower at night before bed. That’s why you have energy in the morning and get tired at night. But throughout pregnancy it naturally increases in both mom and baby.

The placenta—an organ that grows in the uterus during pregnancy to provide oxygen and nutrients to your unborn child—is its own hormone manufacturing plant during pregnancy. It acts like this to ensure fetal development is happening like it’s supposed to do.

The placenta signals the baby and mom to make more cortisol. If cortisol levels don’t return to normal after delivery, there’s an increased risk of postpartum depression.

Ironically, though, the problem isn’t high cortisol after giving birth. It’s low cortisol.

Cortisol levels are high during pregnancy. After pregnancy, they drop. This can cause problems because for months the placenta has signaled the mother’s body to make cortisol. Sometimes, a new mom’s body has to relearn how to make cortisol. That’s why cortisol levels don’t always bounce back right away.

Serotonin

Serotonin is a hormone that makes you feel content, happy, calm, and ready for sleep. You need estrogen in order to convert amino acids into serotonin. When estrogen levels take a tumble after giving birth you may not have enough estrogen to encourage adequate serotonin production. This is especially true if you’re close to menopause.

Oxytocin

Trauma early in life is associated with low oxytocin later. High stress also is not a friend to your oxytocin levels.

What’s more, women who are given synthetic oxytocin (Pitocin) during labor might not make enough oxytocin on their own. Research shows these women have a higher risk of postpartum depression. Sadly, women aren’t often told this when deciding whether to use this drug during labor and delivery.

It Takes a Village but You Likely Don’t Have One

It’s not just hormonal issues that are causing your depression. To make matters worse, you’re also exhausted. Caring for a baby is 24-hours a day, non-stop.

You’re not getting together with your friends. You’re losing sleep. You’re often not eating balanced meals or at regular intervals and you’re not exercising like you used to do.

You might also be feeling a loss of sense of self.

We used to live in villages where aunts, uncles, grandparents, siblings, and cousins all helped with the care of a child. Today’s women are feeling the lack of overall support networks. This leads to feeling isolated. New mothers and fathers often have to do the work of a whole village. These feelings of isolation and overwhelm are even worse in women with postpartum depression and anxiety.

Sure, some couples have the support of grandparents that live nearby. But in many cases, grandparents live in distant cities or states and are only visiting for a short while after the birth.

Don’t hesitate to build your support network. Ask for help. Call on friends and family. Use Facebook mother/parent groups in your local area. Check out postpartum support groups through your OBGYN’s office or lactation support organizations. For those who have a religious or spiritual leaning, there are many community resources provided by synagogues, mosques, or churches. Gyms sometimes have childcare rooms to give you a break while you do self-care. Hire help for childcare or housework. Motherhood isn’t something we can do alone.

Risk Factors for Postpartum Depression and Anxiety

You’re more likely to suffer from postpartum depression if you:

Had major depression prior to pregnancy
Experienced high levels of stress before or during pregnancy
Have a history of trauma
Had a traumatic birth.***
Struggled with anxiety disorder prior to pregnancy
Have a history of insomnia or other disruption in your circadian rhythm
Have high testosterone, which occurs more often in women with polycystic ovarian syndrome
Are low in oxytocin
Have low thyroid hormone levels
Have a history of severe premenstrual syndrome (PMS)
Your natural drop in estrogen and progesterone is particularly severe
Fall into the category of low socioeconomic status

***Traumatic births are not often acknowledged by medical professionals and good options for healing and recovery aren’t well publicized. Many people don’t know where to start or that they could get help with this. There are therapists, counselors, and support programs available for women who experienced birth trauma.

Racial Differences in Postpartum Depression

There’s an important fact to bring to light. It’s that women of color who suffer from postpartum depression often don’t receive the right treatment. Postpartum depression care and awareness in all women is lacking. However, there are definite racial and ethnic differences in postpartum treatment.

For example, in one study, 9% of white women began postpartum mental health care, compared with only 4% of Black women and 5% of Latinas. Blacks and Latinas were significantly less likely to begin treatment for postpartum depression compared with whites. Among those who did begin treatment, Blacks and Latinas were less likely to receive follow-up treatment or continued care compared with white women.

Of the new mothers who started taking antidepressant medication, Black women and Latinas weren’t as likely as white women to refill a prescription.

Research shows that BIPOC women experience postpartum depression at a rate of nearly 38%. Meanwhile, the rate is much lower—only 13% to 19%—when statistics include all women with postpartum depression.

Promote Equal Postpartum Care for Mothers of Color

There are certain action steps we can take to make sure mothers receive healthy, safe, fair pregnancy and postpartum care. We recommend you read this Center for American Progress article, which offers a number of great suggestions on what policy-makers, health care providers, and you, can do to support mothers in underserved communities. Here are other steps you can take to bring about social change for this serious problem affecting mothers of color.

Amplify and support women of color-led organizations.
Support policies that improve work-family balance for women in the workplace.
Support the Shades of Blue Project, an organization focusing on maternal mental health in underserved communities, before, during, and after childbirth.
Donate to the National Birth Equality Collaborative (NBEC), an organization that provides training, research, and other assistance for the issue of black maternal mortality.
Support the National Association to Advance Black Birth, an organization founded to help provide training and access to midwives and doulas of color and lower pregnancy-related deaths.
Support the Black Mamas Matter Alliance, an organization that educates and advocates for better legislation to reduce black maternal mortality. They highlight needed research, and spread information about the social determinants of health that influence outcomes like traumatic birth or maternal and infant mortality.

How to Get Rid of Postpartum Depression and Anxiety

If you have postpartum depression and/or anxiety, please know that you don’t have to suffer alone. Here is what I do with my patients who are feeling emotionally and physically debilitated after giving birth. I’ve had a great deal of success with each of these strategies.

Test hormone levels.

I test women’s sex hormones, adrenal, and thyroid markers. I usually use the dried urine test for comprehensive hormones (DUTCH) to look at adrenal hormones (cortisol and DHEA) and sex hormones. This involves collecting a small amount of urine on filtered paper four times per day. I also order blood tests to look at thyroid function.

Various types of therapy.

Here are some I recommend:

In women who have suffered a trauma in the past or who had a traumatic birth, I recommend a type of therapy known as eye movement desensitization and reprocessing (EMDR).
Hypnosis therapy and cognitive behavioral therapy also work really well.
Meditation programs like Ziva can be a powerful tool.
Apollo neuro wearable touch therapy is another interesting solution. You wear it on your ankle or wrist and it emits silent, soothing vibrations that work on your central nervous system.
Body therapies like acupuncture and craniosacral therapy can help.

Hormonal Support and Dietary Supplements

It’s critical you work with a trained functional medicine healthcare practitioner when taking hormones or dietary supplements. He or she can help you use them appropriately for your specific health concerns. They will order testing to find out the root cause of your postpartum depression or anxiety in the first place. Everyone is unique. The problem could be imbalances in hormones like thyroid, cortisol, progesterone, and estrogen. Or the culprit could be nutrient deficiencies, problems with brain chemical imbalances, anemia, etc.

These are the areas I work on with my postpartum patients to kick anxiety and depression:

Oral natural progesterone in appropriate cases
Estrogen (estradiol) support in appropriate cases
Serotonin support, when testing indicates it, and under supervision of a clinician. This involves supplementing with tryptophan or 5-HTP. If your serotonin levels are high, it can be a marker of inflammation and supplementing with tryptophan or 5-HTP can only make things worse.
A prenatal supplement. The same one you used during pregnancy can work wonders on your mood and mental health outlook.
Lactation-safe herbal formulas and nutraceuticals.

At the risk of repeating myself, it is best for you to work with a skilled practitioner on this journey. With that in mind, these products are safe across the board if you’re breastfeeding your baby:

Herb Lore Anxiety Blend tincture. Reduces stress, calms anxiety, fear, and agitation.
Herb Lore Happy Day tincture. For women feeling sorrow, sadness, or depression.
Lavella. An oral lavender essential oil that reduces anxiety and helps with sleep.
Rescue Remedy. For trauma, stress, anxiety, depression, panic attacks, accidents, or injuries. Safe for newborns, pets, siblings, spouses/partners, too!

We Can Help You Feel Happy Again

If you have postpartum depression or anxiety, you’re not alone. We can order the right testing to help you balance your hormones and other factors that can cause your sad mood. We’ll pinpoint the root causes, and design a customized protocol just for you.

Babe, you can get through this rough time. We’ll hold your hand every step of the way to show you exactly what you need to do to feel happiness and joy again.

Your path to a happier life begins with a free 15-minute troubleshooting call. During this chat, I’ll get to know more about what troubles you. If after the call you come on board as a patient, I’ll work with you to get rid of your postpartum depression and anxiety. Book your call today so you can start enjoying the precious moments of a new beginning- for you and your little one.

by Brie Wieselman

Hands over pregnant stomach in the shape of a heart

My Not-So-Glowing Pregnancy Truth: How I Wound Up With Gestational Diabetes (And What I’m Doing About It)

I’ve been really lucky to enjoy every moment of my pregnancy so far. I feel good. I’ll even say I’m “glowing”! I’m so excited to become a mom and really enjoying the journey.

But my pregnancy joy hit a bump in the road after my 26-week appointment.

If you’re a mama-to-be or already have kiddos, you know what happens at the 26-week appointment: testing for gestational diabetes.

My OB and I decided that instead of traditional testing (more on that later) I could test my blood sugar at home.

I’ve never had fasting glucose above 90, so gestational diabetes wasn’t even on my radar. I was stunned when my fasting glucose was 114!

After testing my blood sugar a couple more times, I called my OB. She confirmed what I already knew: I met the clinical requirements for a gestational diabetes diagnosis!

So much for “glowing”...

But, I believe EVERYTHING happens for a reason…

Why I’m Grateful I Have Gestational Diabetes

I know it sounds a little out there… but at then end of the day I’m actually grateful for this diagnosis.

I hope I can remove some of the stigma around gestational diabetes.

A GD diagnosis doesn’t mean you’re doing anything wrong. You can still have a happy, healthy pregnancy.

But I also think it’s high time we take a hard look at the usual suggestions for moms with GD. As I’ll share in this post, what most doctors recommend isn’t the only option.

I’m going to share:

What gestational diabetes is
Testing for GD (and the alternative to traditional testing)
Who gets gestational diabetes and why (you’ll be surprised by this one)
What you can do to manage it (and exactly what I’m doing)

What Is Gestational Diabetes?

Gestational diabetes is basically just high blood sugar that develops (or is first noticed) during pregnancy.

Even women who have 100% normal blood glucose readings before pregnancy can develop gestational diabetes.

Why?

During pregnancy, the placenta, which connects your baby to your blood supply for nutrients and clearing waste, produces high levels of various other hormones. Almost all of these hormones impair the action of insulin in your cells, raising your blood sugar.

Modest elevation of blood sugar after meals is normal during pregnancy. The bigger your baby grows, the more of these insulin-blocking hormones your placenta produces - which is why gestational diabetes is more likely to present in 2nd and 3rd trimester.

Gestational diabetes is diagnosed when fasting glucose is above 100 - but it’s ideal to have it stay at 90 or below. Post-prandial (after meals) glucose above 130 at any time also suggests GD.

Sometime gestational diabetes is called “carbohydrate intolerance” because it’s high levels of carbohydrates that trigger the high blood sugar.

Why Gestational Diabetes Is A Problem

While slightly elevated blood sugar is a normal thing in pregnancy, gestational diabetes is NOT something you should ignore.

If it’s not addressed GD can cause serious issues for mom and baby:

Baby can grow too large (think 9 pounds and up)
Increased risk of preterm birth
Increased risk of respiratory distress syndrome for baby
Increased risk of preeclampsia for mom (high blood pressure)
Increased risk of Type 2 Diabetes down the road for mom AND baby

All of these risks can be mitigated if gestational diabetes is discovered and managed - that’s why all women should be screened for gestational diabetes.

Most cases of gestational diabetes can be managed with diet and exercise alone - but some women do need insulin, as well.

How Do I Know If I Have Gestational Diabetes?

EVERY woman should be screened for gestational diabetes. But we don’t all have to be tested the same way.

The most common test for gestational diabetes is called 3-hour glucose tolerance testing. It works like this: you go to the doctor fasting and have your blood sugar tested. Next, you drink a solution that contains 75 grams of fructose. Then, you’ll have your blood sugar tested every hour for 3 hours after.

My main issue with 3-hour glucose tolerance testing (besides drinking that nasty solution) is this: Who actually consumes 75 grams of sugar in one sitting?

I certainly don’t!

Unless you’re guzzling soda or supersized slushies, you’re probably not taking in this much sugar at once, either. It’s the equivalent of 2 large pancakes with syrup - but even if you DID eat the pancakes, you’d have the fat, fiber, and protein in the rest of the meal slowing your absorption of the sugar into your bloodstream.

Because I don’t eat much refined sugar, I didn’t think this type of testing was ideal for me. I asked my OB if I could test my own blood sugar (fasting and post-meal) at home with my glucometer instead and she agreed.

(Side note: my OB is awesome. Every woman deserves a pregnancy care team they trust. Don’t be afraid to try out a couple different doctors until you find a team that listens, makes you feel heard and understand, and is responsive to YOUR wants. That doesn’t mean they’ll always say yes to what you want - but they should be willing to consider your requests.)

My Test Results

The next day I ran my fasting glucose…..yikes…106?

Pre-pregnancy, I’d never had fasting blood sugar above 90!

Post-meal, I tested at 127 - then later it rose to 141. I knew that wasn’t good.

The next day, my fasting was 114.

(Remember - GD is diagnosed when fasting glucose is above 100 and post-meal rises above 130).

The results were a shock to me - especially because I’d been following a lower-carb, Paleo/keto style diet. In pregnancy, I’d increased my carbs a little - think a gluten free waffle with almond butter, a teaspoon of honey in my tea, or a slice of gluten free bread once a day.

Pregnancy cravings are real - but it’s not like I was eating pints of ice cream or loaves of bread. How could I have gestational diabetes?

Risk Factors For Gestational Diabetes

Once I took a deep breath, I reminded myself of what I already knew:

Even women with totally normal fasting glucose and good general glucose control can wind up with gestational diabetes in pregnancy.

It wasn’t my diet, but my genetics that put me at increased risk for GD:

#1 I have Polycystic Ovarian Syndrome (PCOS) —this leaves me already more prone to insulin resistance

#2 I have a family history of Type 2 Diabetes - and my mom had gestational diabetes in her pregnancy

#3 I’m non-white. Scientists aren’t sure why, but non-white people have an increased risk of gestational diabetes

Being overweight is also a risk factor for gestational diabetes, but not one that I have personally.

Once I accepted that I had GD, I shifted to action mode: how was I going to manage this so I didn’t need insulin injections?

The Normal Treatment For Gestational Diabetes

The standard recommendations for managing GD is a diet high in complex carbs - about 175 grams per day.

Suggested sources of complex carbs are bananas, whole grains, fruit, rice, and oats.

You’ll also need to monitor your blood sugar 4-7 times per day with a glucometer at home.

Many women are even required to meet with a dietitian to help implement these changes (my insurance required this).

If these diet changes can’t manage your blood sugar, the next step is insulin injections.

As a functional medicine practitioner, these recommendations didn’t jibe with me.

What made more sense to me: a modified keto diet and closely monitoring my blood sugar (plus getting gentle exercise - like walking - every day).

My OB agreed that as long as I could keep my fasting glucose under 100 (preferably under 90) and my post-meal under 120, I could do what worked for me.

An Alternative Way To Manage Gestational Diabetes

A modified keto diet (aka low carb) makes sense for managing gestational diabetes because it is carbohydrates that cause the rise in blood sugar.

Eat less carbs and your blood sugar won’t rise as high. It’s pretty simple (and intuitive).

While I’d like to take credit for the idea of using a modified keto diet to manage gestational diabetes, it was actually Dr. Lois Jovanic. Dr. Jovanic is one the the foremost experts on diabetes in pregnancy and previous director and chief scientific officer of the Sansum Diabetes Research Center.

Here’s what she has to say about the standard recommendations:

“Honestly, 175 g of carbohydrate is stupid! Women should be going as low as it takes to keep their blood sugar regularly under 90 mg/dl (5 mmol/L). Women ask me, ‘Do I have to eat carbohydrates?’ and I say, ‘No you do not!’ If you do eat carbohydrates [with GD], you will have to have insulin. It is that simple.”

Nutritional ketosis is actually a natural state for pregnant women: pregnant women have higher circulating blood ketones than non-pregnant women.

So why is the standard recommendation to eat 175 grams of carbs per day?

It’s because of a misguided fear of diabetic ketoacidosis in pregnant women. One sign of diabetic ketoacidosis is high levels of ketones in the urine - but that doesn’t mean that ketosis and ketoacidosis are the same thing.

Some experts even suggest that having circulating ketone is not only normal and safe, but supportive to optimal fetal neurologic and brain development.

What To Eat When You Have Gestational Diabetes

No matter what diet you’re eating, the MOST important thing is to regularly test your blood sugar levels to ensure they stay in the normal ranges. Both too high and too low are dangerous for growing baby - so test regularly.

Testing 4 -7 times a day is a good place to start. Test when you wake up (fasting) and then after each meal. If you blood sugar rises too high after a meal, that’s a sign you ate too many carbohydrates at that meal.

Secondly, it’s important to eat adequate calories and to not go long periods of time between meals. If you’re not eating enough or going too long between meals, you’re more likely to have problems managing your glucose levels.

Dr. Jovanic also recommend avoiding what she calls “naked carbs” or eating carbohydrate-rich foods all by themselves. Instead, pair carbs with fat and protein to slow absorption. (I.e. a handful of crackers by itself vs. crackers with nut butter).

Getting exercise every day also helps manage blood sugar levels.

What I’m Eating Now

Here’s a peek into what a day of eating looks like for me:

Breakfast: 2 eggs with a sprinkle of shredded pasture raised cheese, cooked in pasture raised butter. Topped with a small avocado and a handful of sliced cherry tomatoes. Rasa herbal Koffee with a splash of grass-fed whole cream and a scoop of collagen.

Lunch: steamed veggies (broccoli, cauliflower, zucchini) with tahini sauce and poached salmon.

Snack: chicken liver pate on celery sticks

Dinner: Homemade Tom Kha soup with veggies, chicken, coconut milk, lime juice, coconut aminos, fish sauce, and green curry paste –yum!!

One last important change I made: adding in late night protein, right before bed.

When I first switched to low carb meals, my post-meal glucose dropped right into line. But my fasting glucose in the morning was still too high. Why? It was because of something called the “Dawn Phenomenon.”

The Dawn Phenomenon occurs when your fast overnight (for me, it was 12+ hours between my dinner and breakfast). The extended fast would kick my body into gluconeogenesis, causing my morning fasting glucose to spike (usually between 99 and 106).

Increasing my evening protein (instead of half a chicken breast, I’d eat a whole one) and adding a tablespoon of psyllium husk to help slow glycemic uptake both did the trick: as soon as I made those changes, my fasting glucose dropped below 90 and stayed there.

My Gestational Diabetes Journey (And My Goal In Sharing This)

For now, eating a modified keto diet, exercising, and testing my glucose levels 4-7x times a day is working to manage my gestational diabetes.

My OB and I are both verrrry happy with my results and that I don’t need to use insulin shots. (And I’m sure baby boy is too!)

As my pregnancy progresses, I might need to switch things up: adding a bit more carbs in or dropping my levels down. Regular glucose testing will help me know what to do.

My goal in sharing this information is to help remove the stigma around gestational diabetes and bring light to an alternative way of managing GD that might work better for you.

But keep baby’s safety first in mind: if you have GD, you should talk with your doctor before making any changes to your treatment plan.

Have a doc who’s unwilling to even consider an alternative to the standard recommendations? It might be time to find a doctor who is willing to work with you.

Hang in there, mama! I know how scary a gestational diabetes diagnosis can be - but I also know you can manage it and keep on glowing.

If this resonates with you, I’d be honored to have you book a 20-minute consult with my team. These consults are totally free and a chance for us to share how we are trained to help you!

→ Learn more and book a free consult with my team here.